Assertive Community Treatment for Persons with Severe Mental Disorders: A Controlled Treatment Outcome Study

Abstract

The present study evaluated the efficacy of an Assertive Community Treatment (ACT) program for the seriously mentally ill. Outcomes of the program were assessed at baseline and 12-month follow-up and were compared with that of a control group, which received standard community care. Thirty-six subjects with serious mental disorders participated in the study. Dependent measures included number of hospital admissions and hospital bed days per year, life skills, quality of life, and psychiatric symptoms. Results of 2 x 2 (treatment/control group x baseline / 12-month follow-up) repeated measures ANOVAs indicated that, after 1 year, both treatments lead to a significant reduction in hospital admissions and bed days, and to improvement in life skills. ACT subjects evidenced a greater decrease in psychiatric symptoms compared to control group subjects. In general, markedly more ACT subjects showed reliable clinical change in life skills, quality of life, and psychiatric symptoms than control subjects. Although the ACT did produce greater clinical change than standard case management, it did not produce statistically greater improvement across most domains of functioning in the short term.The assistance of staff from the Stones Corner and Woodridge Community Mental Health Centres is greatly appreciated.

Evaluation of a mental health treatment court with assertive community treatment

“…As found in other studies (e.g. Clarke et al, 2000;Hamernik & Pakenham, 1999), both groups of participants (i.e. those receiving intensive case management and those receiving regular case management) demonstrated gains in a number of areas.…”

The 2009 Schizophrenia PORT Psychosocial Treatment Recommendations and Summary Statements

“…[8][9][10][11][12][13][14][15][16][17][18] In turn, individuals assigned to the ACT condition used fewer emergency services and more outpatient services, including financial and housing assistance, relative to individuals in the control conditions. 13,14,16,19,23 A few studies also found that individuals assigned to the ACT condition reported decreased symptomatology, 17,20,22,24,25 increased medication adherence, 10,17 more contact with the treatment team, 23,26 more days in stable community housing, 7,12,13,17,19,21,25 and greater satisfaction with treatment among patients and their family members relative to the control condition.…”

Annotation: Childhood‐onset schizophrenia: clinical and treatment issues

“…Randomized trials with adults demonstrate that intensive case management and ACT are more effective than treatment as usual in reducing inpatient hospital care, improving housing stability, and are particularly useful for patients at high risk for treatment noncompliance and relapse (for reviews, see Essock, Drake, & Burns, 1998;Lehman et al, 1998a;Scott & Dixon, 1995). More modest effects have been reported for clinical, social, and quality of life outcomes (Hamernik & Pakenham, 1999;Mueser, Bond, Drake, & Resnick, 1998).…”

“…Despite the promise of ACT for the treatment of adult schizophrenia, and the inclusion of older adolescents in some of the randomized trials (e.g., Hamernik & Pakenham, 1999), our review revealed no randomized controlled trials of this approach for youth suffering from schizophrenia. There is, however, a promising literature on treatment and service delivery strategies for youth with severe emotional disturbance and mental health crises that is directly applicable to youth with schizophrenia.…”